Healthcare Provider Details

I. General information

NPI: 1508397951
Provider Name (Legal Business Name): AMANDA MCWHIRTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2017
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E 3900 S
SALT LAKE CITY UT
84124-1300
US

IV. Provider business mailing address

1200 E 3900 S
SALT LAKE CITY UT
84124-1300
US

V. Phone/Fax

Practice location:
  • Phone: 801-268-7111
  • Fax:
Mailing address:
  • Phone: 801-268-7111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number30162
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number14290243-1205
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number8881727
License Number StateID
# 4
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number20270C
License Number StateWY
# 5
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number70586
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: